III. Local Address (if different from Permanent Address) (use the back button to return to the form)

Street, Apartment Number, Optional Additional Line, Post Office Box#, City, State, Postal Code, Country, Telephone Number (including country code and area code)
Enter your current, local address and phone number in the spaces provided if it is different from your permanent address and phone.

IV. Voluntary Self-Identification (use the back button to return to the form)This section can be completed if you did not indicate information in these areas at the time of original employment.

Marital Status
Indicate "Single" or "Married"

If a change in marital status results in a name change, a new Social Security card will need to be presented as verification of the name change

Race or Ethnic Group
Select one from the following list:

American Indian/Alaskan

Black American

Caucasian

Hispanic

Asian/Pacific Islander

None Selected

Do you have a disability?
Indicate "No" or "Yes."

Veteran Status
Select one Veteran status from the following list:

No military status

Active reserves

Inactive reserves

Other veteran

Retired

Special disabled

Vietnam era

V. Emergency Contact (use the back button to return to the form)

Name
Indicate the full name of the individual who should be contacted in an emergency situation.

Telephone Number (Including area code)
Enter the phone number of the individual who should be contacted in an emergency situation. If the telephone number is outside the United States, include the country code.

Relationship
From the list below, select the relationship this individual has to you:

Brother

Daughter

Father

Friend

Mother

Neighbor

Other

Other relative

Roommate

Sister

Son

Spouse

VI. Additional Information (use the back button to return to the form)

If you are a member of a Religious Order
Indicate "Boston College Jesuit" or "Non BC Jesuit or Other Religious Order."

Attach a letter from your order verifying exemption from withholding and confirming direct deposit information

VII. Dependent/Beneficiary Information (use the back button to return to the form)This section is for informational purposes only and is required of all benefits-eligible employees. Student employees, and other non-benefits-eligible employees should NOT complete this section.

If you have more than nine dependent(s)/beneficiary(ies), please list them at the bottom of this form.

Name
Enter the legal name of the dependent/beneficiary.

Social Security Number
Enter the Social Security number of the dependent/beneficiary.

Date of Birth
Enter the dependent/beneficiary’s birth date.

Address (if different from employee)
If the address of the dependent/beneficiary is not the same as yours, enter the different address.

Relationship
Make a selection from the following list to indicate the relationship this individual has to you:

Aunt

Brother

Daughter

Estate

Ex-Spouse

Father

Father-in-law

Friend

Grandchild

Grandfather

Grandmother

Mother

Mother-in-law

Nephew

Niece

Other

Other Relative

Sister

Son

Spouse

Uncle

Full-time Student?
Indicate whether the dependent/beneficiary is a full-time student by indicating "No" or "Yes."

Gender
Indicate whether the dependent/beneficiary is a "Female" or "Male."

Marital Status
Indicate whether the dependent/beneficiary is "Married" or "Single."

VIII. Signature (use the back button to return to the form)
Your signature and the date are required.

Upon completion of the Personal Data Update Form, please:

Check all information carefully

Print the completed form (form prints best if margins are set at 0.5" for all sides)

Sign and date the form

Gather and attach appropriate documentation (if applicable)

Send or bring Personal Data Update Form along with any additional documentation required for the change(s) to the HRSC in Room 100, 129 Lake Street.